Continuous Pain After Hammertoe Surgery

Overview

hammertoes is a painful deformity wherein a toe bends unnaturally and becomes clawlike. This
happens because the tendons of the toe contract abnormally, forcing the toe to bend downward and the middle joint of the toe to protrude upward. Although any toe may be affected, hammertoe usually
affects the second toe. The toe assumes a clawlike position and cannot be straightened out. When someone with hammertoe wears shoes, the toe is constantly rubbed, so walking may become especially
painful if a callus on the sole of the foot or a corn on the top of a toe develops.

Causes

The constant pressure a woman's foot receives in high-heeled shoes due to the force of gravity causes their feet to naturally slide down and press on the lowest point of the shoe so they are not able
to receive enough space and stretch out. The hammertoes result is an eventual
distortion of the woman's toes. The deformity comes as a result of the shortening of muscles inside the toes because the toes become used to being in a bent position, prompting the muscles to fail to
extend any further and become tightened and curbed. At first, toes may still be stretched out if poor footwear is not being worn, yet if the habit is persistent...the person's toes will eventually
become used to the position they are constantly in and muscle fibers inside them will harden and refuse to stretch.

Symptoms

The symptoms of a hammer toe include the following. Pain at the top of the bent toe upon pressure from footwear. Formation of corns on the top of the joint. Redness and swelling at the joint
contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination,
the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the
degree of the deformities and assess any changes that may have occurred.

For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the damaged skin where the corn is located. Then a small section of bone is removed at the level of the
rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the
patient's follow-up visit, so there is no need for the patient to change the bandages at home. The patient is returned to a stiff-soled walking shoe in about two weeks. It is important to try and
stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint. In severe cases of hammertoe deformity a pin may be required to hold the
toe in place and the surgeon may elect to fuse the bones in the toe. This requires several weeks of recovery.

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